Surgical stapler

ABSTRACT

A hemostatic clip applicator useful in the rapid and automatic application of hemostatic clips for the strangulation of tubular members is disclosed. The applicator consists of a main body, a clip magazine externally attached to the main body, clip deforming jaws attached to one end of the main body, a clip feed mechanism located within the main body and an actuating mechanism attached to the feed mechanism and deforming jaws. In operation, one of many hemostatic clips stored in the clip magazine is fed into the main body and guided to the deforming jaws by the interaction of the actuating mechanism and the feed mechanism. When the clip is properly located about a tubular member, further actuation of the actuating mechanism results in the deformation of the clip about the tubular member. Upon further activation of the actuating mechanism, the sequential process of feeding a clip from the magazine and deforming the clip about other tubular members may be rapidly repeated until the supply of clips in the magazine is depleted.

This is a continuation of application Ser. No. 822,096, filed Aug. 5,1977, now abandoned.

BACKGROUND OF THE INVENTION Copending Patent Applications

In copending U.S. Patent Application Ser. No. 822,076, now abandoned,entitled HEMOSTATIC CLIP APPLICATOR filed Aug. 5, 1977, and assigned tothe present assignee, a hemostatic clip applicator for the stangulationof tubular members in a rapid and automatic manner is disclosed. Also,in copending U.S. Patent Application Ser. No. 822,095, now U.S. Pat. No.4,188,953, entitled HEMOSTATIC CLIP filed Aug. 5, 1977, and assigned tothe present assignee, hemostatic clips adapted for utilization in thepresent invention and similar devices is disclosed.

1. Field of the Invention

The invention relates to the field of devices useful in the applicationof hemostatic clips, and more specifically, to devices for theapplication of hemostatic clips used in the strangulation of bloodvessels and other fluid ducts.

2. Prior Art

In a typical surgery procedure, a great many veins, arteries, and otherblood vessels must be severed and closed. This is often a difficult andtime consuming procedure since many vessels are located in obscure areaswhere there is little room in which to work. Thus, it is apparent that adevice which would reduce the time required for closure of blood vesselswould be of great benefit to both the surgeon and the patient.

One prior art attempt to provide a device which can more rapidly close ablood vessel is disclosed by Wood, U.S. Pat. No. 3,326,216. The Wooddevice consists of a hemostat-like instrument which has finger loopportions coupled to jaw portions. The jaw portions are adapted to hold ahemostatic clip therebetween so that the clip may be closed about avessel by bringing the finger loops together. Wood also discloses aseparate cartridge which holds a plurality of clips. When the Wooddevice is to be used, the jaw portions are placed about one clipcontained in the cartridge, and the clip is removed from the cartridgeby the engagement of the clip by the jaw portions. Then when the cliphas been used, a new clip may be placed in the device by returning tothe clip cartridge and inserting a new clip. Two problems are apparentwith the Wood device. First, the hemostatic clips are not automaticallyfed into the jaws of the device, but must be individually placed there.This procedure is time consuming and cumbersome. In addition, the Wooddevice is capable of expanding its jaws wider than the width of a clipcontained therein. Thus, a clip may be accidentally dropped from thedevice causing a great deal of inconvenience and delay.

A second prior art attempt to provide more rapid yet effectivestrangulation of blood vessels and the like is described by Miles, U.S.Pat. No. 3,082,426. Miles discloses a surgicial stapling device whichconsists of finger loops coupled to a pair of arms which terminate injaw portions, the jaw portions being adapted to grasp and hold a tubularmember. The device also has a magazine for holding a plurality of clipsalong the length of one arm, and manually operable clip ejector meansfor placing a clip about the tubular member which is to be closed. Inoperation, the tubular member is first grasped and held by the jawportions of the Miles device. The surgeon then places his index fingeron a button attached to the clip ejector. By urging the button forward,the clip ejector places a clip about the tubular member. Then, the clipmay be deformed about the blood bessel by bringing the pair of fingerloops together. An obvious disadvantage of the Miles device is that itis cumbersome, in that the surgeon must manually move a clip between thejaws of the device while holding the device steady so as not to loosethe grasp of the tubular member. Also, as the clips are used from thecartridge, the button moves farther forward so that it becomes more andmore difficult to reach. Also, this procedure is time consuming in thateach individual clip must be manually fed between the jaws of thestapling device. Furthermore, the construction of the Miles device,particularly in the jaw portions, provides poor visability to thesurgeon since the thickness of the device obscures the vessels which areto be closed.

Another prior art attempt to provide rapid application of hemostaticclips is disclosed by DeCarlo, U.S. Pat. No. 3,740,944. DeCarlodiscloses a gun-like device for suturing and severing blood vessels in athree stage procedure. First, jaws of the device are closed about theblood vessel by the actuation of the gun-like trigger mechanism. Second,a pair of pushers extend through the device and come forward to crimp apair of clips, brought from an internal magazine, about the vessel intwo spaced locations. Third, a blade comes forward from the device uponfurther actuation of the gun-like handles and severes the blood vesselsbetween the two clip locations.

The internal clip magazine of the DeCarlo device uses a pair of leafspring assemblies to index a plurality of pairs of hemostatic clips. Theclips are stored in a pair of index guide rails where they are movedforward in unison by opposing leaf spring assemblies. One leaf springassembly is attached to the moveable main body portion while theopposing leaf spring assembly is affixed to one guide rail. When thegun-like handles are actuated, the leaf spring assembly attached to themain body moves forward and contacts portions of the clips containedwithin the magazine. Further movement of the main body portion movesindividual clips along the index guide rail and ultimately ejects a pairof clips. When a pair of clips has been ejected, the main body portionbegins to return to its orginal static position. During this rearwardmovement of the main body portion, there is a transference of a pair ofclips from the index guide rails to the ejection guide rails. Thistransference occurs when each leaf spring assembly and its correspondingramp portions guide a clip from one index guide rail to the ejectionguide rail where it is available for loading into the front portion ofthe instrument.

One problem with the DeCarlo device is that, due to the three stageoperation, the device is necessarily bulky. This is a major disadvantagein that many surgical procedures require severence and closure of bloodvessels in very limited areas so that a bulky instrument may not be ableto reach the required vessel. The bulkiness of the device also creates afurther disadvantage in that it produces a lack of visibility for thesurgeon. Thus, the very vessel that is to be severed and closed may beobscured since the surgeon may not be able to see around the device. Afurther disadvantage stems from the fact that the DeCarlo device doesnot adapt to the application of a single clip, but only applies a pairof clips to the vessel to be closed. In a great many surgicalprocedures, only the application of one clip is desired while theapplication of two clips would only complicate the severance procedure.

Accordingly, it is a general object of the present invention to providean improved hemostatic clip applicator device for the strangulation ofblood vessels and the like.

It is another object of the present invention to provide an improvedhemostatic clip applicating device which automatically feeds clips toits forward portion and then provides automatic deformation of the clipsabout blood vessels.

It is yet another object of the present invention to provide an improvedhemostatic clip applicator device which provides high visibility to theuser.

It is yet another object of the present invention to provide an improvedhemostatic clip applicator device which has an externally coupled andreplaceable clip cartridge or in the alternative, a disposablehemostatic clip applicator device which has an externally coupled clipcartridge.

It is a still further object of the present invention to provide animproved hemostatic clip applicator device which is incapable ofaccidentally dropping clips from the device.

SUMMARY OF THE INVENTION

A hemostatic clip applicator device useful for rapidly and automaticallyapplying clips for the strangulation of blood vessels and the like isprovided. The device has a clip magazine means coupled to the exteriorof a main body, the clip magazine means being adapted to hold aplurality of hemostatic clips. Attached to one end of the main body is aclip deforming means adapted to hold and crimp a hemostatic clip about ablood vessel. Slideably disposed within the main body is a clip feedmeans which is adapted to move clips from the clip magazine means to theclip deforming means. Coupled to the clip feed means and the clipdeforming means are actuating means. By a sequential forward andrearward movement of the actuating means, a hemostatic clip is fed fromthe clip magazine means into the main body, where it is moved forward tothe clip deforming means and there crimped about a blood vessel or thelike. This sequence of feeding clips to the clip deforming means andcrimping them therein, may be repeated until the plurality of clipslocated in the clip magazine means is depleted.

The novel features which are believed to be characteristic of theinvention, both as to its organization and its method of operation,together with further objects and advantages thereof, will be betterunderstood from the following description in connection withaccompanying drawings in which a presently preferred embodiment of theinvention is illustrated by way of example. It is to be expresslyunderstood, however, that the drawings are for purposes of illustrationand description only and are not intended as a definition of the limitsof the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side view of the clip applicating device of the presentinvention;

FIG. 2 is a top view of the forward portion of the clip applicatingdevice of the present invention, showing the curved jaw portions;

FIG. 3 is an enlarged view of the jaw portions of the present inventionshowing a hemostatic clip closed by the clip applicating device;

FIG. 4 is an enlarged view of the forward portion of the clipapplicating device of the present invention;

FIG. 5 is an enlarged view of the top of the forward portion of the clipapplicating device showing the clip magazine in its relationship to thedevice;

FIG. 6 is an enlarged view of the forward portion of the clipapplicating device of the present invention;

FIG. 7 is a side view of the clip magazine of the present invention;

FIG. 8 is a perspective view of the clip magazine of the presentinvention;

FIG. 9 is a top view of an alternate embodiment of the clip magazinemeans of the present invention;

FIG. 10 is a perspective view of an alternate embodiment of the clipmagazine of the present invention;

FIG. 11 is a side view of an alternate embodiment of the clip magazineand clip magazine spring means of the present invention;

FIG. 12 is a side view of an alternate embodiment of the clipapplicating device of the present invention;

FIG. 13 is a top view of an alternate embodiment of the clip applicatingdevice of the present invention;

FIG. 14 is an enlarged view of a portion of the clip magazine means;

FIG. 15 is a cross-sectional view of the applicating device of thepresent invention taken along lines 15--15 of FIG. 14;

FIGS. 16a and 16b are a top and side view respectively of the lostmotion link means of the present invention; and

FIGS. 17a, 17b and 17c illustrate the progressive movement of a clipwithin the clip magazine means of an alternate embodiment of the presentinvention.

DETAILED DESCRIPTION OF THE INVENTION

A hemostatic clip applicator device is disclosed which is useful inrapidly applying a hemostatic clip about blood vessels and other fluidducts. The hemostatic clip applicator of the present invention may beused with hemostatic clips such as is described in our co-pendingapplication, Ser. No. 822,095, filed on Aug. 5, 1977 entitled"Hemostatic Clip", or with any other suitably adapted hemostatic clip.

Referring to FIG. 1, the hemostatic clip applying device 2 of thepresent invention is shown in its static configuration. Clip applyingdevice 2 has an actuating means comprised of an upper handle portion anda lower handle portion. In the presently preferred embodiment, the upperhandle portion is comprised of upper finger loop 4, and upper fingerloop member 5, while the lower handle portion is comprised of lowerfinger loop 6 and lower finger loop member 7. It can be seen in phantomin FIG. 1 that upper finger loop 4 may be brought to its foward position8, while lower finger loop 6 may be moved to an inward position 10.Upper finger loop 4 and upper finger loop member 5 pivot about upperfinger loop pivot 12 while being biased toward rear stop pin 16 by firstspring means 14. Upper finger loop member 5 is coupled to clip feedblade 18 by feed blade pivot 17.

Clip feed blade 18 is a clip feed means which in the presently preferredembodiment is a blade member adapted to slide through main body 20 bythe forward movement of upper finger loop 4. Upper finger loop 4 willcontinue to move clip feed blade 18 through main body 20 until upperfinger loop member 5 abuts forward stop means 21. The leading edge 24 ofclip feed blade 18 is adapted to correspond to the bail portion ortrailing edge of a hemostatic clip which may be placed in recess 26 byany suitably adapted means. In the presently preferred embodiment,leading edge 24 is "V" shaped. Thus, it can be seen from FIG. 1 thatwhen a hemostatic clip is placed in the clip receiving means formed byrecess 26, the forward movement of upper finger loop 4 will cause clipfeed blade 18 to abut the bail portion of the hemostatic clip and movethe clip toward the forward end of main body 20.

Coupled to the forward portion of main body 20 is a clip deforming meansadapted to deform a hemostatic clip about a blood vessel or the like. Inthe presently preferred embodiment, the clip deforming means iscomprised of upper jaw portion 32 and lower jaw portion 34. Upper jawportion 32 is fixedly coupled to lower finger loop member 7 andpivotally coupled to main body 20, while lower jaw portion 34 is fixedlycoupled to main body 20. When a hemostatic clip has been fed from theclip magazine into recess 26 and moved forward by clip feed blade 18 tojaw portions 32 and 34, the clip may be squeezed about a blood vessel byfirst returning upper finger loop 4 to its rearward position and thenraising finger loop 6 to its phantom position 10 so that upper jawportion 32 closes toward lower jaw portion 34. It is important to notethat the outward movement of upper jaw portion 32 is limited by theabutment of lower finger loop member 7 with lower finger loop stop pin19. Thus, if a hemostatic clip is located in jaw portions 32 and 34, itmay not be accidentally dropped by the over expansion of upper jaw 32.Lower finger loop 6 and lower finger loop member 7 are baised towardtheir static configuration by second spring means 22 so that upper jawportion 32 will return to its open position when lower finger loop 6 isno longer raised to to its phantom position 10. Also shown in FIG. 1 aremounting holes 28 and rivets 30 adapted to couple a clip magazine, whichwill be more fully described hereinbelow, to main portion 20.

FIG. 2 is a top view of the forward portion of clip applying device 2.Illustrated here is the relationship between main body 20, lower fingerloop member 7 and upper jaw portion 32. It can be seen that lower fingerloop member 7 is fixedly coupled to upper jaw portion 32, while thecombination of member 7 and jaw portion 32 is pivotally coupled to mainbody 20 by upper jaw pivot 36. Thus, rotation of member 7 about pivot 36by movement of lower finger loop 6 results in rotation of upper jaw 32about pivot 36. Therefore, inward and outward movement of lower fingerloop 6 will result in movement of upper jaw 32 toward and away fromlower jaw portion 34. Also shown in FIG. 2 is the curved configurationof upper jaw portion 32 and lower jaw portion 34. This curved forwardportion of clip applying device 2 provides the distinct advantage ofimproved visability during usage since the vessel which is to be closedwill be located to one side or the other of the main body 20. Althoughthe presently preferred embodiment of the upper and lower jaw portionsutilizes a curved configuration, other configurations, such as straightjaw portions, may also be used.

FIG. 3 illustrates the jaw portions 32 and 34 as they are closed about adeformed clip 38. This configuration would have resulted from thefeeding of a clip into the jaw portions 32 and 34 by the forwardmovement of upper finger loop 4, followed by the rearward movement ofupper finger loop 4 and then the inward movement of lower finger loop 6.It may be noted that rearward movement of upper finger loop 4 has causedfeed blade 18 to return to its unactuated position, thus exiting jawportions 32 and 34 and recess 26, so that the jaw portions are free toclose about a clip.

FIG. 4 shows in greater detail the forward portion of clip applyingdevice 2, including clip feed blade 18 and its leading edge 24 as it isdisposed in groove 35 in main body 20. It can be seen that a clip 37disposed in recess 26 will be moved forward by the leading edge 24 ofclip feed blade 18 so that the clip 37 and clip feed blade 18 slidewithin the groove 40 in upper jaw portion 32 and groove 42 in lower jawportion 34. As noted in FIG. 2, jaw portions 32 and 34 are curved awayfrom main body 20. Thus, feed blade 18 must be configured so as to becapable of being moved forward through grooves 35, 40 and 42 whilesimultaneously bending away from main body 20 in grooves 40 and 42. Inthe presently preferred embodiment, this capability has been provided byconstructing feed blade 18 of four layers of thin blades of metal in alaminated configuration. The four layers are only coupled at discretepoints so that feed blade 18 is able to move longitudinally through mainbody 20 while curving around grooves 40 and 42 in jaw portions 32 and34. Also shown in FIG. 4 are rivets 30 and mounting holes 28 forcoupling a clip magazine to the clip applicator device 2.

FIG. 5 is a top view of the forward portion of clip applying device 2showing lateral clip magazine 41 replaceably coupled to main body 20 byclip magazine pin 46 disposed in mounting hole 20 and clip leaf spring48 disposed under rivet 30. Hemostatic clips are disposed in clipmagazine housing 44 in a lateral relationship to main body 20 and urgedtoward recess 26 of clip applying device 2 by the spring contact 50 ofcentral clip leaf spring 49. Thus, when clip feed blade 18 is in itsfully retracted position, recess 26 is clear so that a clip may be fedfrom clip magazine housing 44 into recess 26. The clip disposed inrecess 26 is then available for movement to the jaw portions 32 and 34when clip feed blade 18 is moved forward by the actuation of upperfinger loop 4. Both the clip and clip feed blade 18 then move throughgroove 35 in main body 20 and grooves 40 and 42 in upper jaw portions 32and 34 respectively until upper finger loop member 5 has reached itsfarthest forward position. Also shown in FIG. 5 is lower finger loopmember 7 as it is coupled to upper jaw portion 32, so that they both mayrotate about upper jaw pivot 36.

FIG. 6 is a top view of the forward portion of the clip applying device2, showing the lateral clip magazine housing 44 and its associated clipleaf spring 48. It can be seen from this illustration that clip magazinehousing 44 is coupled to main body 20 by a portion of clip leaf spring48 which lies under rivet 30, and by clip magazine pins 46 beingdisposed in mounting holes 28 in main body 20. Thus, to mount lateralclip magazine housing 44 on main body 20, recesses 52 in clip leafspring 48 are urged around the shaft portion of rivet 30 until pins 46can be located in mounting holes 28. When lateral clip magazine housing44 is so positioned, central leaf spring 49 is positioned over the clips37 contained in housing 44 so that leaf spring 49 contacts the clips 37at point 50 and thereby urges them into the main body 20. When the clips37 in clip magazine housing 44 have been depleted, magazine 41 may beremoved and a new magazine installed by lifting housing 44 from mainbody 20 until pins 46 have cleared holes 28 so that clip leaf spring 44may be moved longitudinally out from under rivets 30. When the depletedmagazine 44 has been removed, a new magazine containing a supply ofclips 37 may be installed.

FIG. 7 is a side cutaway view showing in greater detail lateral clipmagazine 41. Clip leaf spring 48 is disposed under rivet 30 so thatcentral clip leaf spring 49 is positioned over clips 37 contained inmagaine housing 44. It can be seen from this FIGURE that central leafspring 49 exerts a pressure on clips 37 at contact point 50 so as tourge the clips individually into recess 26 of main body 20. When clipfeed blade 18 is in its fully retracted position, recess 26 is empty sothat a clip 37 may move into recess 26 and be held there by the urgingof adjacent clips 37. When a clip 37 is to be moved to the jaw portions32 and 34 of clip applying device 2, clip feed blade 18 then slideslaterally through body portion 20 and carries clip 37 from recess 26toward the jaw portions 32 and 34.

FIG. 8 is a perspective view of lateral clip magazine 41, with itsassociated clip leaf spring 48, central clip leaf spring 49 and housing44. Disposed in housing 44 are a plurality of hemostatic clips 37.Central clip leaf spring 49 is positioned so as to urge hemostatic clips37 to exit from housing 44 through the bottom thereof. Also illustratedin FIG. 8 are the mounting means for magazine housing 44, including pins46, and recesses 52 disposed in clip leaf spring 48.

It can be seen from the above description and particularly FIGS. 1, 5and 8 that clip applicating device 2 of the present invention providesan automatic feeding and crimping of hemostatic clips. By simply movingupper and lower finger loops 4 and 6 outwardly and then inwardly, a clipis moved from an external magazine 41, into a receiving means 26, anddisposed in jaw portions 32 and 34 where it is deformed around a bloodvessel or the like. This process of inward and outward movement offinger loops 4 and 6 may be repeated rapidly, so that one vessel afteranother is closed by the hemostatic clips 37, until the supply of clipsin magazine 41 is depleted. At this point a new magazine 41 may besubstituted for the depleted magazine so that vessel closures may becontinued.

The clip applicating device 2 of the present invention provides thefurther advantage of high visability to the user. Because the device 2is of an extremely thin design, essentially the width of currently usedhemostats and because jaw portions 32 and 34 are curved away from themain body 20, a surgeon using clip applying device 2 will have a clearview of the vessel he is closing and, in addition, will be able to reachremote and obscure regions for further vessel closure. In addition, clipapplying device 2 is constructed so as to prevent a clip 37 fromaccidentally dropping from the device, thereby obivating a great deal ofinconvenience and lost time.

FIG. 9 illustrates an alternate embodiment of a clip magazine which maybe externally coupled to clip applying device 2. In this embodiment, amain body spring 54 is permanently coupled to clip applying device 2 byrivets 56. The main body spring 54 is adapted to hold clip housing 62 inits proper alignment with main body 20 in conjunction with housing pins64. Main body spring 54 includes a central body spring 55 adapted torest upon the clips 37 disposed in clip housing 62. FIG. 9 alsoillustrates a top view of protective cover 66 which is removed from cliphousing 62 when housing 62 is to be utilized. Protective cover 66prevents clips 37 from becoming dislodged from clip housing 62 untilhousing 62 is placed properly in its relationship to main body 20.

FIGS. 10 and 11 further illustrate the alternate embodiment of a clipmagazine. FIG. 10 is a perspective view of clip housing 62 showing aplurality of hemostatic clips 37 disposed therein. Clip housing 62includes housing shoulders 68 and housing pins 64. FIG. 11 is a sideview of clip housing 62 as it is held in place against main body 20 byhousing leaf spring 58 resting on shoulders 68. Main body spring 54 iscoupled to the main body 20 by rivet 56 so that main body springportions 54 rest against shoulders 68 of clip housing 62 while clip leafspring 60 rests against the upper most hemostatic clip 37.

FIG. 12 illustrates clip applying device 2 which utilizes anotheralternate embodiment of a clip magazine, in this case a parallel clipmagazine 70. Disposed in parallel clip magazine 70 is a plurality ofhemostatic clips which lay parallel to main body 20 and are sequentiallyfed toward recess 26. Parallel clip magazine 70 is replaceably coupledto main body 20 by magazine couplings 72, which in the presentlypreferred embodiment are spring clips which snap over correspondingportions of main body 20. The magazine 70 is so adapted that forwardmovement of upper finger loop 4 and the corresponding movement of upperfinger loop member 5 and clip feed blade 18 results in the sequentialplacement of hemostatic clips in recess 26. Further actuation of upperfinger loop 4 results in movement of a clip between upper jaw portion 32and lower jaw portion 34. When a clip has been so placed, upper fingerloop 4 is returned until it abuts rear stop pin 16 at which time lowerfinger loop 6 may be moved inward so as to cause upper jaw portion 32 tomove toward lower jaw portion 34 and thereby close the hemostatic clipabout the blood vessel. Upper finger loop 4 is biased toward stop pin 16by first spring 14, while lower finger loop 6 is biased toward lowerfinger loop member stop pin 19 by second spring means 22.

FIG. 13 is a top view of clip applying device 2 showing parallel clipmagazine 70 and its coupling 72 to main body 20. Also shown in FIG. 13is the relationship between upper finger loop 4, lower finger loop 6,and lower finger loop member 7 as it is coupled to upper jaw portion 32.Lower finger loop member 7 is fixedly coupled to upper jaw portion 32,while lower finger loop member 7 is pivotally coupled to main body 20 byupper jaw pivot 36. Thus, movement of lower finger loop 6 results inmovement of upper jaw portion 32 about upper jaw pivot 36. It can beseen from FIGS. 12 and 13 that parallel clip magazine 70 provides evengreater visability to the surgeon since the magazine 70 only slightlyincreases the width of the clip applying device 2.

FIGS. 14, 15, 16 and 17 generally illustrate that parallel clip magazine70 is comprised of a parallel clip magazine housing 94, which has aplurality of inwardly biased leaf springs 76, a lost motion link 82 anda clip loading blade 78 which also has a plurality of inwardly biasedleaf springs 88. More specifically, FIG. 14 illustrates leaf springs 76in clip housing 94 and the configuration of hemostatic clip 37 withinhousing 94. It can be seen that each leaf spring 76 has a "V" shapedleading edge 77 which is adapted to correspond to the "V" shaped bailportion of clips 37. As will be discribed more fully hereinbelow, thefunction of each leaf spring 76 is to prevent rearward movement of clips37.

FIG. 15 is a cross-sectional view of magazine 70 as it is coupled tomain body 20 by magazine couplings 72. Magazine coupling 72 is adaptedto spring outward around main body 20 until it can be positioned innotch 96 in main body 20. Disposed within parallel clip magazine 70 areinwardly biased leaf springs 76 in housing 94, clip loading blade 78,with inwardly biased leaf springs 88, along with lost motion link 82.Adjacent lost motion link 82 is clip feed blade 18 of clip applyingdevice 2. FIGS. 16a and 16b show in greater detail lost motion link 82.FIG. 16a, a top view of lost motion link 82, illustrates lost motionlink pin 86 and slot 84. FIG. 16b is a side view of lost motion link 82also illustrating pin 86 and slot 84. Pin 86 is fixedly coupled to oneend of lost motion link 82, while slot 84 is an elongated aperturedisposed entirely through link 82.

The operation of parallel clip magazine 70 can be best understood fromthe sequence illustrated in FIGS. 17a, 17b and 17c. In FIG. 17a parallelclip magazine 70 is shown coupled to main body 20. Disposed withinparallel clip magazine 70 are leaf springs 76 extending inwardly fromhousing 94, clip loading blade 78 with inwardly extending leaf springs88, and lost motion link 82. Adjacent lost motion link 82 is the clipfeed blade 18, of applying device 2, which has a feed blade pin 90attached thereto. In FIG. 17a clip feed blade 18 is in its fullyretracted position so that a hemostatic clip 37 is located in recess 26of main body 20. Hemostatic clip 37 is held in recess 26 by clip guidespring 92. Disposed within parallel clip magazine 70 are a plurality ofhemostatic clips 37 which will be sequentially moved into recess 26 bythe urging of leaf springs 88 coupled to clip loading blade 78. It canbe seen in FIG. 17a that feed blade pin 90 is located in the extremeright hand portion of slot 84 in lost motion link 82 and that cliploading blade 78 is coupled to lost motion link 82 by lost motion linkpin 86.

In FIG. 17b it can be seen that clip feed blade 18, which is coupled toupper finger loop 4, has been moved forward so that the clip 37 whichwas in recess 26 has been moved along its path toward the jaw portions.Correspondingly, feed blade pin 90 has freely moved the length of slot84 in lost motion link 82, the distance A, so that neither lost motionlink 82 nor clip loading blade 78 has had a forward movement. Thus,during the initial portion of the loading sequence of clip magazine 70,hemostatic clips 37 disposed within the magazine 70 have not moved,while the clip 37 which was located in the recess 26 has been movedtoward the device jaws.

However, it can be seen in FIG. 17c that further forward movement ofclip feed blade 18 caused by the forward movement of upper finger loop 4has resulted in a forward movement of lost motion link 82 because pin 90which was abutting the forward most portion of slot 84 in lost motionlink 82, has moved a distance B. Thus, this subsequent forward movementof clip feed blade 18 has resulted in forward movement of lost motionlink 82 and corresponding forward movement of pin 86. Forward movementof lost motion link pin 86, in turn, has caused forward movement of cliploading blade 78 and its associated leaf springs 88. Thus, the totalforward movement of pin 90 a distance C has resulted in hemostatic clips37 being moved forward and ultimately the forward most hemostatic clip37 being guided onto the upper surface of clip feed blade 18, aboverecess 26 by clip spring 92. When clip feed blade 18 is returned to itsstatic position by the return of upper finger loop 4, clip 37 will dropinto recess 26 so that it will be ready to be fed to the jaw portions asillustrated in FIG. 17a.

During the later stages of the return movement of feed blade 18, cliploading blade 78 will also undergo a rearward movement. During thisrearward movement of loading blade 78, leaf springs 88 will abut a clip37 and bend outward sufficiently so that the blade 78 is not impeded.When the blade leaf springs 88 have cleared the clips 37, they willreturn to their inward biased position. Clips 37 are prevented fromundergoing a rearward movement by the protrusion of leaf springs 76 inhousing 94. That is, the bail portions of clips 37 abut the leading edgeof leaf springs 76 and are prevented from moving rearward. On the otherhand, forward movement of clips 37 is accomplished by the abutment ofthe leading edge of leaf springs 88 with the bail portion of clips 37.As springs 88 move forward due to the movement of blade 78, clips 37bend housing leaf springs 76 outward until they have passed theprotruding portions of the springs 76. In this manner, one completeforward movement of upper finger loop 4 will cause each clip 37 toprogress to the next location just ahead of the next succeeding housingspring 76.

The proper alignment of both leaf springs 76 and 88 in theirrelationship to clips 37 is accomplished by the location of rear stoppin 16 and forward stop means 21. The rear stop pin 16 is positioned sothat abutment of upper finger loop member 5 with pin 16 results insufficient movement of clip loading blade 78 so that loading blade leafsprings 88 stop slightly behind each adjacent clip 37. This positioningof pin 16 ensures that each leaf spring 88 will be able to move theadajacent clip 37 forward. The forward stop means 21, on the other hand,is positioned so that abutment of upper finger loop member 5 results insufficient forward movement of leaf springs 88 so that each clip 37 isplaced just beyond the rearward adjacent leaf spring 76. Thus, theprevention of rearward movement of clips 37 is ensured since each leafspring 76 is always behind the forward adjacent clip 37.

There has been described herein a new and novel clip applying devicewhich has special utility for applying hemostatic clips to blood vesselsand the like. However, it is to be understood that various alternateembodiments using the principles of the present invention may be readilyincorporated. Thus, while specific embodiments of the present inventionhave been disclosed and described in detail herein, it will beunderstood by those skilled in the art that various changes in form anddetail may be made therein without departing from the spirit and scopeof the invention.

We claim:
 1. A surgical clip applying device comprising:(i) a main bodyhaving means for receiving clips; (ii) a clip magazine coupled to theexterior of said main body and having a housing adapted to store aplurality of said clips in a parallel relationship with said main body,said housing including a plurality of inwardly biased leaf springs;(iii) clip loading means slideably disposed within said housing formoving said clips from said magazine to said clip receiving means, saidclip loading means comprising a blade member having a plurality of leafsprings disposed thereon so as to be in substantially opposedrelationship with said leaf springs of said housing, said leaf springsof said housing and said leaf springs of said loading blade having a"V"-shaped leading edge so as to engage the correspondingly shapedportions of said clips, whereby said leaf springs of said loading bladesequentially move said clips to said clip receiving means while saidleaf springs of said housing prevent movement of said clips away fromsaid clip receiving means; (iv) clip deforming means coupled to saidmain body for deforming clips disposed therein; (v) clip feed meansslideably disposed within said main body for moving said clips from saidclip receiving means to said clip deforming means, said clip feed meansadapted to slide through said main body into said clip deforming meansso as to place a clip therein, and to retract from said deforming meansprior to the actuation of said deforming means; and (vi) actuating meanscoupled to said clip feed means, said clip loading means and said clipdeforming means for actuating said clip feed means, said clip loadingmeans, and said clip deforming means.
 2. The clip applying device ofclaim 1 wherein said magazine further includes a lost motion link memberadapted to associate with said clip feed means, said link memberslideably disposed within said housing and coupled to said loading meanswhereby initial forward movement of said feed means does not result inforward movement of said loading means while additional forward movementof said feed means results in forward movement of said loading means. 3.The clip applying device of claim 2 wherein said housing furtherincludes a guide spring coupled thereto, said guide spring adapted tourge said clips from said housing into said main body clip receivingmeans.
 4. The clip applying device of claim 3 further including acoupling mechanism adapted such that said magazine may be coupled to anddecoupled from said main body.
 5. A surgical clip applying devicecomprising:(i) a main body having a clip receiving recess; (ii) a clipmagazine coupled to said main body and adapted to hold a plurality ofclips, said magazine having a plurality of inwardly biased leaf springsadapted to prevent movement of said clips away from said clip receivingrecess; (iii) clip deforming means coupled to said main body fordeforming clips disposed therein; (iv) a clip loading blade slideablydisposed in said clip magazine, said loading blade having a plurality ofleaf springs adapted to engage and sequentially move said clips fromsaid magazine to said clip receiving recess; (v) a clip feed bladeslideably disposed within said main body and adapted to sequentiallymove said clips from said clip receiving recess to said clip deformingmeans, said clip feed blade adapted to slide through said main body intosaid clip deforming means so as to place a clip therein, and to retractfrom said deforming means prior to the actuation of said deformingmeans; and (vi) an actuating mechanism coupled to said clip deformingmeans, said clip loading blade, and said clip feed blade wherebyactuation of said actuating mechanism sequentially causes said cliploading blade to slide through said clip magazine so as to sequentiallymove said clips to said clip receiving recess, said clip feed blade toslide through said main body into said deforming means and returntherefrom so as to sequentially move said clips from said clip receivingrecess to said clip deforming means, and said clip deforming means todeform said clips disposed therein.
 6. The clip applying device of claim5 further including coupling means for coupling said magazine to anddecoupling said magazine from said main body.
 7. The clip applyingdevice of claim 6 wherein said actuating mechanism comprises an upperhandle portion pivotally coupled to said main body and said clip feedblade, and a lower handle portion fixedly coupled to said deformingmeans, whereby movement of said upper handle portion toward saiddeforming means results in movement of said clip feed blade toward saiddeforming means while urging of said upper handle portion toward saidlower handle portion results in the deforming of a clip by said clipdeforming means.
 8. The clip applying device of claim 7 wherein saidclip magazine further includes a lost motion link slideably disposedtherein, said lost motion link coupled to said clip loading blade andsaid clip feed blade whereby initial forward movement of said clip feedblade toward said deforming means does not result in movement of saidclip loading blade while additional movement of said clip feed bladetoward said deforming means results in movement of said clip loadingblade toward said deforming means.
 9. The clip applying device of claim5 wherein said clip magazine further includes a lost motion linkslideably disposed therein, said lost motion link coupled to said cliploading blade and said clip feed blade whereby initial forward movementof said clip feed blade toward said deforming means does not result inmovement of said clip loading blade while additional movement of saidclip feed blade toward said deforming means results in movement of saidclip loading blade toward said deforming means.
 10. The clip applyingdevice of claim 9 further including coupling means for coupling saidmagazine to and decoupling said magazine from said main body.
 11. Theclip applying device of claim 10 wherein said actuating mechanismcomprises an upper handle portion pivotally coupled to said main bodyand said clip feed blade, and a lower handle portion fixedly coupled tosaid deforming means, whereby movement of said upper handle portiontoward said deforming means results in movement of said clip feed bladetoward said deforming means while urging of said upper handle portiontoward said lower handle portion results in the deforming of a clip bysaid clip deforming means.
 12. The clip applying device of claim 5wherein said actuating mechanism comprises an upper handle portionpivotally coupled to said main body and said clip feed blade, and alower handle portion fixedly coupled to said deforming means, wherebymovement of said upper handle portion toward said deforming meansresults in movement of said clip feed blade toward said deforming meanswhile urging of said upper handle portion toward said lower handleportion results in the deforming of a clip by said clip deforming means.13. The clip applying device of claim 12 further including couplingmeans for coupling said magazine to and decoupling said magazine fromsaid main body.
 14. The clip applying device of claim 5 wherein saidclip magazine further includes a lost motion link slideably disposedtherein, said lost motion link coupled to said clip loading blade andsaid clip feed blade whereby initial forward movement of said clip feedblade toward said deforming means does not result in movement of saidclip loading blade while additional movement of said clip feed bladetoward said deforming means results in movement of said clip loadingblade toward said deforming means.